Abstract
Introduction: The most frequent subtype of breast cancer is the luminal one, in 70 to 80% of cases; the poor response to neoadjuvant chemotherapy of these tumors positions neoadjuvant hormone therapy as a treatment option. Materials and Methods: An observational, descriptive, historical cohort study was conducted in patients with hormone receptor (HR positive and HER2-positive breast cancer, managed with neoadjuvant hormone therapy in the INC (National Cancer Institute, for its initials in Spanish), with the aim of evaluating their clinical and pathological response. Results: 57 patients were managed with neoadjuvant hormone therapy. Most stage IIA patients (40.3%, n = 23). 86% (n = 49) had luminal A tumors. Letrozole was the most widely used drug, in 78.9% (n = 45). The overall response rate (ORR) was reached in 94.6% (n = 53); and 10.7% of the patients (n = 6) achieved complete clinical response (cCR). Complete pathological response (pCR) was achieved only in one patient. Conservative surgery was possible in 56.9% (n = 29) of the patients. There was no difference between the type of aromatase inhibitor (AI) and the duration of neoadjuvant hormonal treatment with the clinical response. With a median follow-up of 3 years (0.6 and 6 years), no disease progression was reported in any of the patients in the study. Conclusion: The results of this study support the neoadjuvant hormone therapy recommendations for postmenopausal patients older than 65 years with luminal breast cancer, with well or moderately differentiated tumors, strongly HR positive and low Ki 67.
Highlights
The most frequent subtype of breast cancer is the luminal one, in 70 to 80% of cases; the poor response to neoadjuvant chemotherapy of these tumors positions neoadjuvant hormone therapy as a treatment option
Endocrine therapy was initially proposed by Sir George Beatson, a surgeon from Glasgow, who around 1896 performed a bilateral oophorectomy in a patient with breast cancer, with good results for controlling the disease
This same surgeon performed an oophorectomy on a younger patient with breast cancer, who did not present a favorable response to treatment [25]
Summary
Breast cancer is the most common malignancy in women. According to Globocan data for 2018, 2.1 million (11.6%) of new cases were diagnosed, and there occurred 626,679 (6.6%) deaths from breast cancer. Regarding the type of agent that should be used to start neoadjuvant treatment with hormone therapy, several studies have been carried out [13,14,15] These studies compared letrozole or anastrozole versus tamoxifen; study P024 found clinical response rates of 55% in the letrozole group compared to 36% in patients who received tamoxifen (p
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